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Ventricular assist device
Definition
Ventricular assist devices (VAD) help your heart pump blood from one of the main pumping chambers of your heart (the left ventricle) to the rest of your body or other side of the heart. These pumps may be implanted in your body or connected to a pump outside your body.
Alternative Names
VAD; RVAD; LVAD; BVAD; Right ventricular assist device; Left ventricular assist device; Biventricular assist device; Heart pump; Left ventricular assist system; LVAS; Implantable ventricular assist device
Description
A ventricular assist device has three parts:
- A pump. The pump weighs 1 to 2 pounds. It is placed inside or outside of your belly.
- An electronic controller. The controller is like a small computer that controls how the pump works.
- Batteries. The batteries are carried outside your body. They are connected to the pump with a cable that goes into your belly
You will need general anesthesia when your VAD is implanted. This will make you unconscious and unable to feel pain during the procedure.
During surgery to implant the pump, the heart surgeon opens the middle of your chest with a surgical cut and then separates your breastbone. This allows the surgeon to reach your heart. Next, the surgeon will make space for the pump under your skin and tissue in the upper part of your belly wall. Then, the surgeon will place the pump in this space.
A tube will connect the pump to your heart. Another tube will connect the pump to your aorta or one of your other major arteries. Another tube will be passed through your skin to connect the pump to the controller and batteries.
The VAD will take blood from your left ventricle through the tube that leads to the pump. Then the device will pump the blood back out to one of your arteries and through your body.
Surgery usually lasts 4 to 6 hours.
Why the Procedure Is Performed
You may need a VAD if you have severe congestive heart failure that cannot be controlled with medicine, a special pacemaker, or other treatments. You may be on a waiting list for a heart transplant. Some patients who get a VAD are very ill and may already be on a heart-lung bypass machine.
Not every patient with severe heart failure is a good candidate for this procedure.
Risks
Risks for this surgery are:
- Blood clots in the legs that may travel to the lungs
- Blood clots that form in the device
- Breathing problems
- Heart attack or stroke
- Allergic reactions to the anesthesia medicines used during surgery
- Infections
Before the Procedure
Most people will already be in the hospital for treatment of their heart failure.
After the Procedure
Most people who are put on a VAD spend up to 5 days in the intensive care unit after surgery. You may stay in the hospital anywhere from 2 to 8 weeks after you have had the pump placed. During this time you will learn how to care for the pump.
Outlook (Prognosis)
A VAD may help people who have congestive heart failure live longer. It can also help improve quality of life.
References
Mcmurray JJV, Pfeffer MA. Heart failure: management and prognosis. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 59.
Mehra MR, Griffith BP. Assisted circulation in the treatment of heart failure. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald'sHeart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa:Saunders; 2011:chap 32.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
